Addis Meeting between Minister of Health and CSOs

One outcome of the Ministerial Conference on Immunization in Africa that took place February 24-25 in Addis Ababa, Ethiopia was the meeting that took place between Nigeria’s Minister of Health Professor Isacc Adewole and Nigeria’s Civil Society Organizations (CSOs) under the auspices of National Immunization Financing Task Team (NIFT).

The meeting took place in the early hours of 23^rd February 2016. It was aimed to interact with the Minister and inform him of country efforts to ensure equitable access to immunization in Nigeria. The CSOs was led by the NIFT Chairman Dr. Ben Anyene who informed the Minister that since the inauguration of NIFT in March, 2015 by the Executive Director of National Primary Health Care Development Agency (NPHCDA) Dr Ado J Muhammad following approval of the NPHCDA board, the task team has carried out a lot of activities to ensure sustainable immunization financing in Nigeria through its Evidence Generation, Advocacy, Local Vaccine Production, and Fund Raising subcommittees.

NIFT is also currently pushing for the inclusion in 2016 budget of the Basic Health Care Provision Fund (BHCPF) earmarked in the National Health Act as it will provide close to N5billion for vaccines which will help in narrowing the fund gap for immunization.

The position of the Nigerian Immunization CSOs were presented to the minister as follows;

1. Nigeria has made remarkable progress in its immunization program which resulted in the interruption of poliovirus transmission in 2014.
2. While immunization coverage rates have improved recently, gaps in coverage and equity remain a concern.
3. Although under-5 mortality has dropped by nearly half between 1990 and 2015, an unacceptably large number of children – 750,000 – still die every year. About 28% of these deaths can be partially or fully attributed to Vaccine Preventable Diseases (VPDs).
4. Nigeria now faces a huge fund gap for its immunization program due to rising birth cohort, introduction of new vaccines and a transition from Gavi support. Yet there are broader macro-economic challenges.
5. To address issues of sustainable immunization financing, the NPHCDA established the NIFT to advice on and coordinate efforts on advocacy, evidence generation, fund raising and local vaccine production.

The CSOs called on the government of Nigeria to increase immunization funding;

1. By harnessing existing funds: Implementing the Basic Health Care Fund can realize about 5 billion Naira for vaccines annually.
2. By expanding the fiscal space: Setting up a National Immunization Fund that will draw public and private contributions for immunization, is an innovative idea (e.g. through telecommunications) to support government fund immunization programs. Management of the fund should be transparent and credible to avoid a potential public push back.
3. Commit to supporting a legislation to back the immunization fund to ensure accountability
4. Strengthen primary health care systems to deliver facility-based, outreach and mobile immunization services, through a strong health workforce equipped to reach all communities
5. Ensure that all Nigerians, especially the poorest and most marginalized, have access to immunization and other essential health services through Universal Health Coverage
6. Strengthen the supply chain to assure uninterrupted purchase and delivery of vaccines in sufficient quantity to meet the population’s needs.
7. Attain all Six Global Vaccines Action Plan (GVAP) goals by 2020, with special emphasis on meeting the national and sub-national Penta 3 coverage rate target. This includes ensuring that all data required to track GVAP indicators are being collected.
8. Collaborate more with civil society organizations and the media towards increasing coverage rates, reducing inequity, ensuring accountability, raising community demand for immunization.
9. Commit to quarterly dialogues with CSOs to obtain feedback from the field and respond to CSO questions.

In the same meeting the Immunization CSOs in Nigeria pledged to work with the government of Nigeria to achieve the following;

1. Assist the government of Nigeria to improve the performance and management of primary health care system that deliver vaccines.
2. Hold government of Nigeria and its immunization-related MDAs accountable (through dialogue and problem solving) for delivering immunization services to all communities, especially the poorest and most marginalized members of society.
3. Support and contribute to advocate for sustainable immunization financing in Nigeria.

The Minister for Health Professor Isaac Adewole at the end of the meeting committed to equitable access to immunization especially to the poor nigerians in the rural areas. He also committed to work with CSOs and expressed his willingness to interact with CSOs on quarterly basis in order to improve accountability to Immunization and Primary Health Care in general.

In concluding this article, I have to stress on the need for NIFT to hit the ground running and work with other CSO coalitions to organise the 1^st quarterly interactive meeting soonest.

All comments to Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)